WBC Review and Leukemia Worksheet answers PDF

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WBC Review and Leukemia Worksheet Answers 1. White blood cells are also known as: Leukocytes 2. Name the primary function of WBCs: Protect body from infection and tissue injury. 3. The normal WBC count is: 5000-10,000 cells/mm3 4. A low WBC count is known as: leukopenia 3. The most common type of WBC is: Neutrophil These originate in the : bone marrow 4. “PMNs” or “segs” are terms used to describe what type of neutrophil? Mature 5. Select the type of white blood cell (WBC) that fits the related description: a. Basophils

b. Eosinophils

c. Lymphocytes

d. Monocytes

-Comprise 24-40% of WBCs; nucleus is spherical and takes up most of the cell; has two main types (B and T); function in immunity: Lymphocytes -The largest WBCs, they become macrophages and function in chronic inflammations: Monocytes -Contain histamine, involved in allergic responses: Basophils -Increase in number during parasitic responses: Eosinophils -Agranulocytes (2 answers): Monocytes and Lymphocytes 6. Select the type of leukemia that fits each description below: a. ALL

b. AML

c. CLL

d. CML

-The most common type of leukemia in children and young adults:ALL -The most common type of cancer that follows treatment for a primary cancer; has low percentage cure rate: AML -Most likely to affect older adults; often diagnosed by enlarged lymph nodes: CLL

-Associated with Philadelphia chromosome; patients are often asymptomatic in early stages: CML 7. A 4 year old boy is admitted with a diagnosis of acute lymphoid leukemia (ALL). What signs and symptoms most commonly characterize the early stages of acute leukemia? Low grade fever, pallor, bone pain and a tendency to bruise top the list of early signs and symptoms of leukemia. A patient may also have listlessness, enlarged lymph nodes, abdominal pain, constipation, liver and spleen enlargement, petechiae, headache, vomiting and anorexia, unsteady gait, adenopathy, low platelet and RBC count, and elevated white blood cell blast count. 8. What diagnostic test is used to confirm the diagnosis of ALL? What client teaching/preparation should be done before the test? a. A bone marrow biopsy is used to make the diagnosis of ALL. Bone marrow with 25% blast cells confirms the diagnosis. b. Obtain a written consent prior to the procedure. For pediatric patients, conscious sedation may be used. Remind the patient to remain very still throughout the procedure. Tell the patient he will probably feel burning during the lidocaine infiltration, and pressure as the needle enters the bone, and when the syringe plunger is withdrawn for aspiration. Let the patient know that he may be apprehensive when pressure is applied to puncture the outer table of the bone. Assess the coagulation studies before the test and report any evidence coagulopathy to the MD. Normally the patient will need to be on bedrest for 30 to 60 minutes after the procedure. 9. What is the most common cause of death in children with leukemia? The most common cause of death is infection due to immunosuppression and the body’s inability to fight infection. The child’s immature white blood cells are incapable of normal phagocytosis of micro-organisms. 10. What is the main reason why children with leukemia are prone to bleeding episodes?

There is decreased formation of platelets and red blood cells in leukemia because of the uncontrolled growth of immature WBCs. A child is prone to bleeding when a low number of platelets exist. 11. Which children are considered to have the best prognosis when diagnosed with ALL? The best prognosis is a low initial WBC and an age of 2-9 years, and the worst prognosis is an initial WBC of 50,000/mm3 or higher and an age younger than 2 years and older than 10 years. Girls have a better prognosis than boys. 12. What are the 2 phases of chemotherapy used to treat leukemia? What is the purpose of each phase? a. Induction: goal is to reduce the cancer to an undetectable level, known as remission. Chemotherapy doses are high during this phase and cause suppression of the normal blood cell production. Often a combination of drugs are used in this phase. About 95% of children with ALL are able to achieve remission during induction. b. Postremission: Is aimed at eradicating any residual leukemic cells, prevent relapse, and prolong survival. This may include continued medications, or bone marrow transplant. 13. What should be included in the nursing management of a child with ALL? a. Manage bleeding: -monitor susceptibility to bleeding. Assess for signs of bleeding (petechiae, bruising, urine, stools, platelet counts). -limit amount of blood sticks and invasive procedures. -protect mucous membranes. Use soft bristled brush or sponge. Avoid rectal thermometers. b. Minimize risk of infection: -use meticulous hand washing and teach client and family to do the same. -monitor VS for s/s of infection. Monitor neutrophil levels. -assess for any potential signs of infection (pain, erythema, induration)

-use aseptic technique for all invasive procedures. c. d. d. e. f.

Control vomiting. Assess/observe for CNS symptoms: headache, vision changes, seizures. Manage pain. Provide adequate hydration Maintain nutrition -provide well balanced meal with preferred foods. -offer small amounts of fluids frequently. -frequent oral care. -bland, cool, foods and fluids every two hours. g. Provide emotional support for patient and family....